Provider Demographics
NPI:1306095872
Name:AGUILA, ANISLEY
Entity type:Individual
Prefix:
First Name:ANISLEY
Middle Name:
Last Name:AGUILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12460 SW 8TH ST
Mailing Address - Street 2:SUITE#204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-1437
Mailing Address - Country:US
Mailing Address - Phone:305-553-0334
Mailing Address - Fax:305-553-0336
Practice Address - Street 1:12460 SW 8TH ST
Practice Address - Street 2:SUITE#204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1437
Practice Address - Country:US
Practice Address - Phone:305-553-0334
Practice Address - Fax:305-553-0336
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993281163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299993281OtherAHCA LISENCE NUMBER